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Published: Thursday, 7/23/2009

President Obama takes health-care reform plan to Cleveland


SHAKER HEIGHTS, Ohio - President Barack Obama Thursday sought to turn up the heat on lawmakers to swiftly enact health care reform in a direct appeal to middle-class America via suburban Cleveland.

The hour-long town hall meeting with a ticket-only crowd of roughly 3,000 was largely a sequel to Wednesday night's prime-time televised press conference in which the President of less than seven months hinged the nation's personal health and economic future on reform.

He down played his prior demand that a bill reach him before lawmakers recess in August, a self-imposed deadline that some legislative leaders have said is overly optimistic.

"I want to get it right, but I also want to get it done promptly,'' Mr.

Obama told the crowd at Shaker Heights High School. "As long as I see people working diligently and consistently, I am comfortable with moving a process forward that builds as much consensus as possible. What I don't want to see is delay for the sake of delay. Delay because people are afraid of making tough votes.''

He urged those in the crowd to contact members of Congress with personal stories of how they've been affected by rising health care costs.

The town hall followed a quick tour of the cardiac unit at nearby Cleveland Clinic, which he said epitomizes his goal of providing the best care and lower cost. The clinic has not endorsed his health care proposal.

"Cleveland Clinic has one of the best health information technology systems in the country,'' he said. "This means that they can track patients and their progress. This means that they can see what treatments work and what treatments are unnecessary. It means they don't have to duplicate test after test because it's all online.

"They actually have some of the lowest costs for the best care,'' Mr. Obama sad. "The interesting thing about our health care system is that often better care provides lower costs, not higher expenses.''Mr. Obama praised the Cleveland Clinic's emphasis on preventive care.

"It's exciting that, in addition to a big fancy hospital with big fancy equipment, they're also linked up with family clinics through the area,'' he said. "One of the things the clinic and family physicians focus on is preventable disease. They're making sure that someone is helped with a nutritionist to keep their weight down before they get diabetes as opposed to paying for surgery for a foot amputation.''

Concerns over the price tag and how to pay for it have dampened prospects for quick congressional passage of a bill by the president's initial deadline of early August.

"Our target date is to get this done by the fall. That's the bottom line,''

he told high-school freshman Parker Smith, who questioned whether it was all "too much too fast.''

"Even if it got done in the fall, most of these changes would be phased in over several years, phased in in an intelligent and deliberate way,'' Mr.

Obama said. "This is not too much too soon. We are not completely scrapping the existing health care system.''

Although he's won general endorsements for reform from the likes of the American Medical Association that eluded the last major attempt at health care reform under President Bill Clinton in the early 1990s, Mr. Obama's plan seems to be hitting some of the same roadblocks that ultimately defeated its predecessor.

Mr. Obama outlined broad guidelines for reform, calling for allowing those who are happy with the private insurance they have now to keep it while creating a public alternative for those who don't have coverage through employers and can't afford private policies. He said the public component would also increase competition for private insurers to maintain downward pressure on premiums.

He said he won't support a plan that adds "even one dime'' to what is already a record budget deficit and has insisted that any taxes to help pay for it should not imposed on the middle class. A bill that has emerged from a House panel would raise taxes on individuals earning at least $280,000 or more or families earning at least $350,000 while House leadership has talked more about taxing families earning more than $1 million.

House Minority Leader John Boehner (R., Ohio) charged in a conference call with reporters that Mr. Obama was using Ohio to promote a bill that will lead to the loss of jobs, health care rationing, and a denial of services.

"Despite what President Obama is promoting, his bill would make health care more expensive,'' he said. "It is a $1.6 trillion monstrosity . The Congressional Budget Office has estimated that it would add $240 billion to our deficit over the next 10 years. Beyond those 10 years we have an exploding deficit as a result of this proposal.''

Mr. Obama has insisted reform could partially pay for itself through costs savings from better efficiency, preventive care that wards off more serious and expensive ailments, and decreased misuse of hospital emergency rooms for expensive non-emergency treatment.

President Obama also laid the deficit at the feet of Republicans.

"If you are a taxpayer concerned about deficits, I want to reassure you, I am too. In the eight years before we came to office, Washington enacted two large tax cuts, primarily for the wealthiest Americans, added a prescription drug benefit to Medicare, and funded two wars, without paying for any of it," he told the town hall gathering.

"The national debt doubled, and we were handed a $1.3 trillion deficit when we walked in the door."

The President was also not shy about going after current GOP leaders.

"We have never been closer to achieving quality, affordable health care for all Americans. But at the same time, there are those who seek to delay and defeat reform," he said. "I've heard that one Republican strategist told his party that even though they may want to compromise, it's better politics to 'go for the kill.' Another Republican senator said that defeating health reform is about 'breaking' me - when it's really the American people who are being broken by rising health care costs and declining coverage.

"And the Republican Party chair, seeking to stall our efforts, recently went so far as to say that health insurance reform was happening 'too soon,' " Mr. Obama said. "I thought that was a little odd. We've been talking about health reform since the days of Harry Truman, and he's saying reform is coming too soon."

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